Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
권호 표지

여중생의 철분 영양 상태와 체질량 지수와의 관계

The iron status and the relationship between iron deficiency and body mass index in middle school girls

  • 한희연 (인하대학교 의과대학 소아과학교실) ;
  • 장주희 (인하대학교 의과대학 소아과학교실) ;
  • 심혜선 (인하대학교 의과대학 소아과학교실) ;
  • 홍영진 (인하대학교 의과대학 소아과학교실) ;
  • 손병관 (인하대학교 의과대학 소아과학교실) ;
  • 김환철 (인하대학교 의과대학 산업의학과) ;
  • 김순기 (인하대학교 의과대학 소아과학교실)
  • Han, Hee Youn (Department of Pediatrics, Inha University College of Medicine) ;
  • Chang , Joo Hee (Department of Pediatrics, Inha University College of Medicine) ;
  • Shim, Hae Sun (Department of Pediatrics, Inha University College of Medicine) ;
  • Hong, Young Jin (Department of Pediatrics, Inha University College of Medicine) ;
  • Son, Byong Kwan (Department of Pediatrics, Inha University College of Medicine) ;
  • Kim, Hwan Cheol (Department of Occupational and Environmental Medicine, Inha University College of Medicine) ;
  • Kim, Soon Ki (Department of Pediatrics, Inha University College of Medicine)
  • 투고 : 2006.08.23
  • 심사 : 2006.09.13
  • 발행 : 2006.11.15
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

목 적 : 비만과 철 결핍은 가장 중요한 영양문제이다. 비만아에서 철 결핍이 더 많다는 주장이 있지만, 국내에서는 이와 상반된 의견이 제시된바 있다. 본 연구는 인천지역 여중생의 비만과 철 결핍의 유병률을 알아보고 이들 사이에 어떤 관계가 있는지 알아보았다. 방 법 : 2005년 5월 인천시에 거주하는 14, 15세의 여중생 764명을 대상으로 신체 측정과혈액 검사를 실시하였다. 비만은 체질량지수 85 백분위수 이상을 비만으로 정하였다. 철 결핍은 페리틴이 10 ng/mL 미만으로 정의하였고, IDA는 혈색소가 12g/dL 미만이면서 페리틴 10 ng/mL 미만 또는 트랜스페린 포화도가 16% 미만인 경우로 정의하였다. 결 과 : 1) 인천시 여중생의 과체중 유병률은 24.4%(n=186)였다. 비만도에 의한 비만의 유병률은 16.5%(n=126)였다. 페리틴과 트랜스페린 포화도는 정상 체중군에서 가장 낮았다. 2) 철 결핍의 유병률은 18.7%(n=102), IDA의 유병률은 5.3%(n=41)였다. 3) BMI에 따른 철분 영양 상태를 보았을 때, 과체중군과 저체중군보다 정상체중군에서 철 결핍의 유병률이 높았다. 또한 비만군보다 비비만군이 철 결핍과 철 결핍성 빈혈의 유병률이 높았다. 결 론 : 인천 지역 여중생의 비만 유병률은 다른 지역보다 높은 경향을 보였다. 그러나 철 결핍은 크게 차이가 나지 않았다. 또한 정상 체중군에서 철 결핍이 많은 것으로 나타났다. 이는 비만군에서 음식섭취가 많아 철분의 섭취량도 많기 때문에 정상체중군에 비하여 비만군에서 철 결핍이 적은 것으로 생각된다.

Purpose : Obesity and iron deficiency are common nutritional problems. Obese children are known to have iron deficiencies, but one presented opposite opinion in Korea. This study investigated the prevalence of obesity and iron deficiency in Incheon and the relationship between iron deficiency and obesity. Methods : Physical measurement and hematologic examinations were done a 764 healthy female students aged 14 to 15 years in May, 2005. Overweight was defined as a body mass index ${\geq}85th$ percentile. Iron deficiency was defined as serum ferritin <10 ng/mL. Iron deficiency anemia (IDA) was defined as serum Hb <12 g/dL and serum ferritin <10 ng/mL and/or transferrin saturation <16%. Results : 1) The prevalence of overweight was 24.4 percent (n=186), and that of obesity 16.5 percent (n=126). Ferritin and transferrin saturation was the lowest in the normal weight group. 2) The prevalence of iron deficiency and IDA was 18.7 percent (n=102) and 5.3 percent (n=41), respectively. 3) Iron deficiency was more common in the normal weight group compared with the overweight and underweight groups. Also, the non-obese had more iron deficiency and IDA than the obese. Conclusion : The prevalence of obesity in middle school girls could be higher in Incheon than in other regions, but there might be no difference in iron deficiency. However, iron deficiency was more prevalent in the normal weight group than in overweight group. The overweight group ate more food and gained more iron, so seemed to be less prevalent in iron deficiency than the normal weight group.

키워드

과제정보

연구 과제 주관 기관 : 인하대학교

참고문헌

  1. Wu AC, Lesperance L, Bernstein H. Screening for iron deficiency. Pediatr Rev 2002;23:171-8 https://doi.org/10.1542/pir.23-5-171
  2. Nead KG, Halterman JS, Kaczorowski JM, Auinger P, Weitzman M. Overweight children and adolescents: a risk group for iron deficiency. Pediatrics 2004;114:104-8 https://doi.org/10.1542/peds.114.1.104
  3. Yager JY, Hartfield DS. Neurologic manifestations of iron deficiency in childhood. Pediatr Neurol 2002;27:85-92 https://doi.org/10.1016/S0887-8994(02)00417-4
  4. Greydanus DE, Patel DR. The female athlete, before and beyond puberty. Pediatr Clin North Am 2002;49:553-80 https://doi.org/10.1016/S0031-3955(02)00005-6
  5. Meier PR, Nickerson HJ, Olson KA, Berg RL, Meyer JA. Prevention of iron deficiency anemia in adolescent and adult pregnancies. Clin Med Res 2003;1:29-36 https://doi.org/10.3121/cmr.1.1.29
  6. Sandoval C, Jayabose S, Eden AN. Trends in diagnosis and management of iron deficiency during infancy and early childhood. Hematol Oncol Clin North Am 2004;18:1423-38 https://doi.org/10.1016/j.hoc.2004.07.005
  7. Umbreit J. Iron deficiency. In: Rakel RE. Bope ET. Conn's Current Therapy. 57th ed. Philadelphia: WB Saunders Co, 2005:433-5
  8. Glader B. Iron deficiency anemia. In: Behrman RE, Kliegman RM, Jenson HB. Nelson Textbook of Pediatrics. 17th ed. Philadelphia:WB Saunders Co, 2004:1614-6
  9. Duffy TP. Microcytic and hypochromic anemia. In: Lee G, Ausiello D: Cecil Textbook of Medicine, 22nd ed. Philadephia:WB Saunders Co, 2004;1003-6
  10. Zlotkin S. Clinical nutrition: 8. The role of nutrition in the prevention of iron deficiency anemia in infants, children and adolescents. CMAJ 2003;168:59-63
  11. Cho JR, Kim SK, Park SK. Hah JO. Anemia and serum iron status in adolescent female. J Korean Pediatr Soc 2002;45:362-9
  12. Kim MH, Kim TW, Hong YJ, Son BK, Pai SH, Chang KJ, et al. The prevalence of obesity and underweight in adolescents in Incheon area and the relationship between serum cholesterol level and obesity. J Korean Pediatr Soc 2002;45:174-82
  13. Kang YJ, Hong CH, Hong YJ. The prevalence of childhood and adolescent obesity over the last 18 years in Seoul area. Korean J Nutrition 1997;30:832-9
  14. Song YJ, Joung HJ, Kim YN, Paik HY. The physical development and dietary intake for Korean children and adolescents:body composition and obesity prevalence. Korean J Nutrition 2006;39:44-9
  15. Looker AC, Dallman PR, Carroll MD, Gunter EW, Johnson CL. Prevalence of iron deficiency in the United States. JAMA 1997;277:973-6 https://doi.org/10.1001/jama.277.12.973
  16. Koletzko B, de la Gueronniere V, Toschke AM, Kries R. Nutrition in children and adolescents in Europe: what is the scientific basis? introduction. Br J Nutr 2004;92(Suppl2):67-73 https://doi.org/10.1079/BJN20041168
  17. Strauss RS, Pollack HA. Epidemic increase in childhood overweight, 1986-1998. JAMA 2001;286:2845-8 https://doi.org/10.1001/jama.286.22.2845
  18. Han YS, Joo NM. An analysis on the factors of adolescence obesity. Korean J Food Culture 2005;20:172-85
  19. Scheer JC, Guthrie HA. Hemoglobin criteria with respect to obesity. Am J Clin Nutr 1981;34:2748-51 https://doi.org/10.1093/ajcn/34.12.2748
  20. Pinhas-Hamiel O, Newfield RS, Koren I, Agmon A, Lilos P, Phillip M. Greater prevalence of iron deficiency in overweight and obese children and adolescents. Int J Obes Relat Metab Disord 2003;27:416-8 https://doi.org/10.1038/sj.ijo.0802224
  21. Han SJ, Hong YJ, Son BK, Choi JW, Hyun IY, Kim SK. Iron statsus in Korean middle school students and possible association with obesity. Korean J Hematol 2005;40:159-66 https://doi.org/10.5045/kjh.2005.40.3.159
  22. Hah JO, Kang MH, Kim JH. Prevalence study of anemia among urban and rural middle school girl students. Korean J Pediatr 1990;33:1087-96
  23. Park SK, Kim HM, Jeong JY, Park SJ, Park JH, Kim SR, et al. A study of iron status and anemia among urban and rural middle school students. Korean J Hematol 1999;6:235-49
  24. Kim SK, Lim DH, Choe YH, Jeon YH, Hong YJ, Son BK, et al. The prevalence of iron deficiency and iron deficiency anemia in Korean adolescents. Korean J Hematol 1998;33:215-23
  25. Cho JR, Kim SK, Park SK, Hah JO. Anemia and serum iron status in adolescent female. J Korean Pediatr Soc 2002;45:362-69
  26. Kim MJ, Kang JS, Go JW, Hong YJ, Ahn DH, Paek DM, et al. The percentiles of body mass index and trend of obesity in schoolage children in Seoul. J Korean Pediatr Soc 1999;42:756-64
  27. Ogden CL, Flegal KM, Carroll MD, Johnson CL. Prevalence and trends in overweight among US children and adolescents, 1999-2000. JAMA 2002;288:1728-32 https://doi.org/10.1001/jama.288.14.1728
  28. Sim SJ, Cheon KS, Park HS. The relation of serum lipid profiles to overweight among children in Gangeung area. J Korean Soc Obes 2003;12:146-53
  29. Hong SC, Hwang SW, Hyun IS. Relationship of adolescent obesity and cardiovascular risk factor and childhood obesity in high school student in Jeju Island. Korean J Health Edu Prom 2003;20:113-25
  30. Kim SK, Hong YJ, Choi JW, Pai SW, Son BK. The prevalence of iron deficiency and iron deficiency anemia in Korean adolescents. Intern J Pediatr Hematol/Oncol 1998;5:455-61
  31. Hong SM, Seo YU, Hwang HJ. A Study of the iron status and anemia in middle school girls resided in Ulsan metropolitan city. J Hum Ecol 2003;7:77-9
  32. Lee IY, Lee LH. Prevalence of obesity among adolescent girls in Seoul and its relationship to dietary intakes and environmenta factors. Korean J Nutr 1986;19:41-51
  33. Poulain M. Doucet M, Major GC, Drapeau V, Series F, Boulet LP, et al. The effect of obesity on chronic respiratory disease :pathophysiology and therpeutic strategies. CMAJ 2005;174: 1293-9
  34. Obesity. In:An HS editor. Hong CE. Pediatrics. 8th ed. Seoul. Daehan Printing & Publishing Co 2004:98-102
  35. Failla ML, Kennedy ML, Chen ML. Iron metabolism in genetically obese(ob/ob) mice. J Nutr 1988;118:46-51 https://doi.org/10.1093/jn/118.1.46
  36. Son SJ, Lee EJ, Choi BS, Park MH. An analysis of food intake pattern of obese children and nutritional intake. Proceedings of the Korean Nutrition Society Conference;2001 May 26, Seoul. Seoul: The Korean Nutrition Society 2001:153